Can leukocyte antisedimentation rate (LAR) predict septic complications and critical care survival early in polytrauma and burn victims?

Martin Rozanovic, Csaba Csontos, L. Bogár, Lívia Szélig, Tímea Bocskai, Patrícia Kovács, Marianna Matancic, Attila Miseta, Csaba Loibl

Research output: Contribution to journalArticle

Abstract

BACKGROUND: In polytrauma and burn injury Systemic Inflammatory Response Syndrome (SIRS) develops. SIRS is presented in many hospitalized patients, including those who never develop infection or sepsis. Both in SIRS and sepsis the leukocyte activation occurs. In acute phase reaction leukocytes' upward flotation i.e. leukocyte antisedimentation rate (LAR) can indicate infectious origin. OBJECTIVE: To evaluate the predictive power of LAR, serum C-reactive protein (CRP) and procalcitonin (PCT) levels regarding mortality risk and development of septic complications. METHODS: In a prospective, observational study, 36 patients were followed for 5 days (T1-T5) after admission to a critical care unit immediately with severe polytrauma or burn injury. Eleven patients developed septic complications, their LAR, CRP and PCT levels were analyzed before and after 3 days of sepsis was declared. RESULTS: Ten patients died due to septic complications. In survivors LAR at T1 (p<0.001) and T2 (p<0.001) as well as CRP at T1 (p<0.05) were significantly higher compared to controls and non survivors. In septic patients LAR (p<0.05) and CRP (p<0.05) showed a significant drop one day before sepsis was declared. PCT levels failed to predict this. CONCLUSIONS: Drop in LAR and CRP levels may be warning signs regarding the onset of septic complications after severe polytrauma and burn injury.

Original languageEnglish
Pages (from-to)875-885
Number of pages11
JournalClinical Hemorheology and Microcirculation
Volume64
Issue number4
DOIs
Publication statusPublished - 2016

Fingerprint

Multiple Trauma
Critical Care
Leukocytes
Survival
C-Reactive Protein
Systemic Inflammatory Response Syndrome
Sepsis
Calcitonin
Survivors
Wounds and Injuries
Acute-Phase Reaction
Observational Studies
Blood Proteins
Prospective Studies
Mortality
Infection

Keywords

  • C-reactive protein
  • inflammatory response
  • leukocyte antisedimentation rate
  • Mechanical and heat trauma
  • procalcitonin

ASJC Scopus subject areas

  • Physiology
  • Hematology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Can leukocyte antisedimentation rate (LAR) predict septic complications and critical care survival early in polytrauma and burn victims? / Rozanovic, Martin; Csontos, Csaba; Bogár, L.; Szélig, Lívia; Bocskai, Tímea; Kovács, Patrícia; Matancic, Marianna; Miseta, Attila; Loibl, Csaba.

In: Clinical Hemorheology and Microcirculation, Vol. 64, No. 4, 2016, p. 875-885.

Research output: Contribution to journalArticle

Rozanovic, Martin ; Csontos, Csaba ; Bogár, L. ; Szélig, Lívia ; Bocskai, Tímea ; Kovács, Patrícia ; Matancic, Marianna ; Miseta, Attila ; Loibl, Csaba. / Can leukocyte antisedimentation rate (LAR) predict septic complications and critical care survival early in polytrauma and burn victims?. In: Clinical Hemorheology and Microcirculation. 2016 ; Vol. 64, No. 4. pp. 875-885.
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AU - Rozanovic, Martin

AU - Csontos, Csaba

AU - Bogár, L.

AU - Szélig, Lívia

AU - Bocskai, Tímea

AU - Kovács, Patrícia

AU - Matancic, Marianna

AU - Miseta, Attila

AU - Loibl, Csaba

PY - 2016

Y1 - 2016

N2 - BACKGROUND: In polytrauma and burn injury Systemic Inflammatory Response Syndrome (SIRS) develops. SIRS is presented in many hospitalized patients, including those who never develop infection or sepsis. Both in SIRS and sepsis the leukocyte activation occurs. In acute phase reaction leukocytes' upward flotation i.e. leukocyte antisedimentation rate (LAR) can indicate infectious origin. OBJECTIVE: To evaluate the predictive power of LAR, serum C-reactive protein (CRP) and procalcitonin (PCT) levels regarding mortality risk and development of septic complications. METHODS: In a prospective, observational study, 36 patients were followed for 5 days (T1-T5) after admission to a critical care unit immediately with severe polytrauma or burn injury. Eleven patients developed septic complications, their LAR, CRP and PCT levels were analyzed before and after 3 days of sepsis was declared. RESULTS: Ten patients died due to septic complications. In survivors LAR at T1 (p<0.001) and T2 (p<0.001) as well as CRP at T1 (p<0.05) were significantly higher compared to controls and non survivors. In septic patients LAR (p<0.05) and CRP (p<0.05) showed a significant drop one day before sepsis was declared. PCT levels failed to predict this. CONCLUSIONS: Drop in LAR and CRP levels may be warning signs regarding the onset of septic complications after severe polytrauma and burn injury.

AB - BACKGROUND: In polytrauma and burn injury Systemic Inflammatory Response Syndrome (SIRS) develops. SIRS is presented in many hospitalized patients, including those who never develop infection or sepsis. Both in SIRS and sepsis the leukocyte activation occurs. In acute phase reaction leukocytes' upward flotation i.e. leukocyte antisedimentation rate (LAR) can indicate infectious origin. OBJECTIVE: To evaluate the predictive power of LAR, serum C-reactive protein (CRP) and procalcitonin (PCT) levels regarding mortality risk and development of septic complications. METHODS: In a prospective, observational study, 36 patients were followed for 5 days (T1-T5) after admission to a critical care unit immediately with severe polytrauma or burn injury. Eleven patients developed septic complications, their LAR, CRP and PCT levels were analyzed before and after 3 days of sepsis was declared. RESULTS: Ten patients died due to septic complications. In survivors LAR at T1 (p<0.001) and T2 (p<0.001) as well as CRP at T1 (p<0.05) were significantly higher compared to controls and non survivors. In septic patients LAR (p<0.05) and CRP (p<0.05) showed a significant drop one day before sepsis was declared. PCT levels failed to predict this. CONCLUSIONS: Drop in LAR and CRP levels may be warning signs regarding the onset of septic complications after severe polytrauma and burn injury.

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